Individual provider Active NPI

Nilde S Cordoliani, PHD

  • Clinical Psychologist
  • Ponce, PR
National Provider Identifier
1063747533
Registry record updated Oct 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
046 Issued in PR
Practice address
2604 Ave Las Americas
Constancia
Ponce, PR 00717-2107
Phone
(787) 844-3077
NPI assigned
Oct 16, 2009
Last updated
Oct 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 046 PR Primary

Addresses

Primary practice location

2604 Ave Las Americas
Constancia
Ponce, PR 00717-2107

Mailing address

1915 Calle Zarina
Valle Real
Ponce, PR 00716-0510
Phone (787) 975-9968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
046PRMDClinical Psychologist
46PRMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Holistico Bienestar Mental Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1063747533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 CALLE ZARINA",
            "address_2": "VALLE REAL",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007160510",
            "telephone_number": "787-975-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 AVE LAS AMERICAS",
            "address_2": "CONSTANCIA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172107",
            "telephone_number": "787-844-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOLIANI",
        "first_name": "NILDE",
        "middle_name": "S",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.